A combination strategy for enhancing linkage to and retention in HIV care among adults newly diagnosed with HIV in Mozambique: study protocol for a site-randomized implementation science study.
Background: Despite the extraordinary scale up of HIV prevention, care and treatment services in sub-Saharan Africa (SSA) over the past decade, the overall effectiveness of HIV programs has been significantly hindered by high levels of attrition across the HIV care continuum. Data from "real-life" s...
| Published in: | BMC Infectious Diseases Vol. 14; no. 1; pp. 549 - 550 |
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| Main Authors: | , , , , , , , , , , , |
| Format: | research randomized controlled trial Journal Article |
| Published: |
BioMed Central
2014
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=103852282&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 103852282 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 14712334 1CHU jtl: BMC Infectious Diseases issn: 14712334 maglogo: N pubinfo: dt: 2014 vid: 14 iid: 1 pid: 24147 pub: BioMed Central artinfo: ui: 103852282 103852282 NLM25311998 2012782062 10.1186/s12879-014-0549-5 NLM25311998 PMC4210581 103852282 ppf: 549 ppct: 1 formats: tig: atl: A combination strategy for enhancing linkage to and retention in HIV care among adults newly diagnosed with HIV in Mozambique: study protocol for a site-randomized implementation science study. aug: au: Elul, Batya Lahuerta, Maria Abacassamo, Fatima Lamb, Matthew R Ahoua, Laurence McNairy, Margaret L Tomo, Maria Horowitz, Deborah Sutton, Roberta Mussa, Antonio Gurr, Danielle Jani, Ilesh affil: ICAP, Columbia University, New York, NY, USA. be2124@cumc.columbia.edu. sug: subj: Anti-HIV Agents Therapeutic Use Patient Compliance Adult CD4 Lymphocyte Count Protocols Cost Benefit Analysis HIV Infections Diagnosis HIV Infections Immunology Motivation Mozambique Multicenter Studies Clinical Information Systems Clinical Trials Reminder Systems Quality of Health Care Text Messaging Human Adult: 19-44 years ab: Background: Despite the extraordinary scale up of HIV prevention, care and treatment services in sub-Saharan Africa (SSA) over the past decade, the overall effectiveness of HIV programs has been significantly hindered by high levels of attrition across the HIV care continuum. Data from "real-life" settings are needed on the effectiveness of an easy to deliver package of services that can improve overall performance of the HIV care continuum.Methods/design: We are conducting an implementation science study using a two-arm cluster site-randomized design to determine the effectiveness of a combination intervention strategy (CIS) using feasible, evidence-based, and practical interventions-including (1) point-of-care (POC) CD4 count testing, (2) accelerated antiretroviral therapy initiation for eligible individuals, and (3) SMS reminders for linkage to and retention in care-as compared to the standard of care (SOC) in Mozambique in improving linkage and retention among adults following HIV diagnosis. A pre-post intervention two-sample design is nested within the CIS arm to assess the incremental effectiveness of the CIS plus financial incentives (CIS + FI) compared to the CIS without FI on study outcomes. Randomization is done at the level of the study site, defined as a primary health facility. Five sites are included from the City of Maputo and five from Inhambane Province. Target enrollment is a total of 2,250 adults: 750 in the SOC arm, 750 in the CIS cohort of the intervention arm and 750 in the CIS + FI cohort of the intervention arm (average of 150 participants per site). Participants are followed for 12 months from time of HIV testing to ascertain a combined endpoint of linkage to care within 1 month after testing and retention in care 12 months from HIV test. Cost-effectiveness analyses of CIS compared to SOC and CIS + FI compared to CIS will also be conducted.Discussion: Study findings will provide evidence on the effectiveness of a CIS and the incremental effectiveness of a CIS + FI in a "real-life" service delivery system in a SSA country severely impacted by HIV.Trial Registration: Clinicaltrials.gov, NCT01930084. pubtype: Academic Journal doctype: research randomized controlled trial Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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